Fixing the healthcare labor crisis

By Hsieh Wen-hui 謝文輝

From time to time the public catches a glimpse of the arduous conditions endured by those who work in healthcare. For example, the nation’s shortage of nurses is now so severe that some hospitals have been forced to cut beds. Internal medicine, surgery, gynecology, pediatrics and emergency treatment are departments in which staff work long hours and often come under intense pressure. As a result, fewer people are now willing to take up these specialties and replace those who retire or resign.

The great majority of hospitals outside major urban areas no longer provide gynecological and pediatric services. In a report entitled A General Health Check for the National Health Insurance Program (健保總體檢), Control Yuan member Huang Huang-hsiung (黃煌雄) examined the topic of key community hospitals in rural and urban townships. In the words of the report: “The government must do all it can to safeguard these hospitals through its formulation of policy. At present there are 50 to 60 such important community hospitals that not only play the role of healthcare guardians, but also take on other social functions in rural and urban townships.”

However, these township hospitals are now suffering from the same problems as those in more out-of-the-way places. Most have for a long time faced a severe shortage of gynecological and pediatric doctors and nurses, while age is taking its toll on those who are still working. It is getting harder to maintain properly functioning gynecological and pediatric healthcare services and this is an issue that the government and general public should take very seriously.

Society expects healthcare workers to have high moral standards. People think that it is the sacred mission of doctors and nurses to work all year round with no vacation, serving the public at all hours of the day and night.

Many healthcare workers themselves have the same ingrained idea. Long working hours are the normal state of affairs for doctors and nurses, and most people think that such selfless service is only to be expected. It is the selfless dedication of healthcare workers that makes it possible for Taiwan’s National Health Insurance program to provide world-class healthcare on a very tight budget.

The convenience with which Taiwanese can seek medical care is unparalleled, as is their unrestrained use of the available services.

Eventually, however, we must face reality and recognize that healthcare is a labor-intensive, technology-intensive and capital-intensive service. Inadequate capital investment and unreasonable overtime are sure to have a negative effect on the quality of service provided. Such conditions also discourage young people from joining the medical profession. If things continue like this, we could face a crisis in which this essential service simply runs out of steam.

This is why healthcare workers have been protesting so much recently. The issue has attracted public attention and the Control Yuan has even proposed corrective measures that it wants to see implemented by government departments in charge of healthcare. These are welcome developments.

What people find most puzzling is the attitude taken by groups representing hospitals, who should be most aware of the heavy workload and difficulties faced by healthcare personnel. People are asking why hospitals oppose government proposals that they should deploy more healthcare personnel and ensure that they work reasonable hours in accordance with the Labor Standards Act (勞動基準法). Their attitude seems to confirm accusations that hospitals are little better than sweatshops.